A team of UCLA researchers are the first to describe the cost throughout the entire process for men being treated for low-risk prostate cancer — from their first appointment to post-treatment follow-up testing.

Analyzing several different types of cancer treatment that were available throughout the entire 12-year study period, the researchers found a wide variance in costs. The research indicates that there may be a better way to monitor costs and keep them in check for patients, said Dr. Aaron Laviana, the study’s first author.

“As we move from traditional fee-for-service reimbursement models to accountable care organizations and bundled payments to curb growing health care expenditures, understanding the true costs of health care is essential,” said Laviana, a resident in the UCLA department of urology. “Traditional costing methods often lack transparency and can be arbitrary, preventing the true costs of a disease or treatment from being understood.”

The study was published Nov. 2 in the peer-reviewed journal Cancer.

Laviana said the study’s biggest surprise was the relatively low cost of active surveillance, an approach in which doctors use repeated prostate-specific antigen testing and prostate biopsies to determine whether more aggressive disease is developing. Active surveillance is an important option, especially for younger, healthier patients who might benefit from delaying treatment, Laviana said, and because it avoids the health complications associated with radiation and surgery, including difficulty urinating and erectile dysfunction.

The researchers found costs ranged from $7,298 for active surveillance to $23,565 for intensity-modulated radiation therapy, or conventional radiation therapy that is delivered in relatively small doses over eight weeks with patients receiving daily treatments during the process.

Robotic-assisted laparoscopic prostatectomy had a relatively high cost of $16,946. Cryotherapy — freezing the tumor — was $11,215.

The researchers took into account personnel capacity cost rates, personnel costs for doctors, nurses and patient affairs staff, as well as space and equipment costs.

In the future, they plan to compare these study results with quality measurements and outcomes to determine which treatments provide the greatest value, and to expand this study to higher-risk forms of prostate cancer.

The study was funded by the H and H Lee Surgical Research Scholars Program.

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